Clinical Documentation Integrity Specialist, Remote
Midland, MI / Huntsville, AL / Ashland, MS
Provider Networks – Provider Networks & ACO Support /
Full Time /
Remote
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care.
We are searching for a Clinical Documentation Integrity Specialist (CDIS) to join the team. The person in this role will lead field and provider education and training related to complete and accurate diagnostic documentation and coding, in accordance with ICD-10 CM coding guidelines, internal protocols and CMS and payer guidelines. The CDIS will deliver tailored education at the national, market, practice, and individual provider-level; complete end-to-end workflow assessment and optimization; and perform chart reviews to identify specific opportunities for improved accuracy. There will be opportunity to travel periodically to practices as well as engage in remote work. The CDIS must be detail-oriented, service-minded, possess strong verbal and written communication skills, and be fluent in (or willing and able to master) Google Suite tools.
Primary Duties:
- Perform chart reviews to identify opportunities for better accuracy in clinical documentation and coding. Evaluate and optimize end-to-end practice clinical documentation, billing and coding workflows. Develop and implement action plans to improve the completeness and accuracy of clinical documentation and coding.
- Work directly with Aledade practices and providers on continuous improvement of complete and accurate documentation and diagnosis coding. Facilitate clinical documentation and coding communication amongst key internal and external stakeholders. Provide guidance to field staff and practices regarding general documentation and coding best practices and risk adjustment.
- Deliver internal and external-facing education and training on clinical documentation and diagnosis coding to support value-based contracts.
Minimum Qualifications:
- Essential to perform duties without CDI training.
- Bachelor’s degree in a healthcare related field or equivalent work experience required.
- At least 1 of the following: Current certification as a Certified Professional Coder (CPC), Certified Documentation Expert Outpatient (CDEO®) from AAPC, Certified Clinical Documentation Specialist-Outpatient (CCDS-O) from ACDIS.
- 3+ years of recent, relevant work experience in CDI or 5+ years as a risk adjustment auditor; 3+ years RCM or billing experience.
- Familiarity with anatomy and physiology, disease processes and medical terminology.
- Thorough understanding of medical coding guidelines and regulations including compliance, reimbursement, and the impact of diagnosis documentation on risk adjustment payment models.
- Subject matter expertise on the CMS HCC Risk Adjustment program, methodology, and impact to value-based contracts.
- Ability to identify and communicate opportunities to improve documentation and diagnosis capture for accurate risk adjustment coding.
- Experience working directly with physician practices and individual providers to achieve demonstrable improvement in increasing the accuracy and completeness of documentation and diagnosis coding.
Preferred Key Skills and Abilities:
- Successful track record in outpatient coding and billing through previous experience.
- Self-directed and solution oriented.
- Strong understanding of value-based care principles, particularly as they relate to the impact of clinical documentation and coding on risk adjustment payment models in value-based contracts.
- Strong understanding of outpatient coding and billing.
- Solution-oriented individual who can execute tactical continuous quality improvement work to deliver results in value-based contracts.
- Excellent communicator who can articulate the impact of documentation and diagnosis initiatives to Aledade ACO member practices and their key staff (e.g., office managers, practice billers, etc.), and internally within the company.
- Ability to work collaboratively across Aledade clinical and non-clinical teams to gain buy-in and implement key documentation improvement initiatives.
- References demonstrating high degree of integrity and professional accountability.
Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of payers, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives, and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
What Does This Mean for You?
At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents, and domestic partners Robust time off plan 21 days of PTO in your first year 2 Paid Volunteer Days & 11 paid holidays
12 weeks paid Parental Leave for all new parents
6 weeks paid sabbatical after 6 years of service
Educational Assistant Program & Clinical Employee Reimbursement Program
401(K) with up to 4% match
Stock options
And much more!
At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop, and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance, and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
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